What I talk about in my daily neurology team rounds

Diabetes, old stroke and tPA

On November 22nd, this article in Neurology banished the age old contraindication of Diabetes + prior stroke in the use of tPA. Since there probably won’t ever be an RCT of tPA for stroke + prior stroke + diabetes, this will be the best data we ever get.

Now you can perfectly well maintain that the evidence behind tPA is not the best (and I would second such an opinion) and therefore remain a skeptic (such as thennt.com and emireland), but cannot discrimate against the poor diabetics…

Writing this, I think we should review the evidence of tPA sometime in the near future.